| NPI | 1689734154 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery Sports Medicine (Licence: NJ 25MA10235000) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NY 252952) |
| Enumeration Date | 2006-12-12 |
| Last Update Date | 2023-04-18 |